Internal Medicine Subspecialties?

Started by YA7ES
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YA7ES

YA7ES

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I'm facing a tough decision. I've been accepted to my state MD school and a DO school that I love. As of right now, I want to do a residency in internal medicine (which falls in line with the DO route) and then subspecialize in something like pulmonology or cardiology.
Will being a DO put me at a disadvantage for subspecializing?
Do osteopathic residencies let you subspecialize when you are done?
 
From what I heard on the interview trails, it is much wiser to go to attend an MD residency (even as a DO) if you want to do fellowships.
Plus it's much easier for DO students to get into MD residencies than it is for DOs to get into MD fellowships.
The quantity & quality of DO fellowships leaves a lot to be desired....so if you plan on specialising an allopathic fellowship would be the way to go
 
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FutureInternist said:
From what I heard on the interview trails, it is much wiser to go to attend an MD residency (even as a DO) if you want to do fellowships.
Plus it's much easier for DO students to get into MD residencies than it is for DOs to get into MD fellowships.
The quantity & quality of DO fellowships leaves a lot to be desired....so if you plan on specialising an allopathic fellowship would be the way to go
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I agree 👍
 
Just curious, can a DO student do an MD residency, then do a DO fellowship if he/she wanted to or is he/she done with AOA training with an MD residency?
 
Just Joshin said:
Just curious, can a DO student do an MD residency, then do a DO fellowship if he/she wanted to or is he/she done with AOA training with an MD residency?
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As far as I know you can. Where I went to school there were a couple of cardiology fellows who I am 95% sure they did an allopathic IM residency.

Also of note, I am doing my residency at an allopathic institution where there are DO fellows in IM subspecialties including cardiology.

I would however agree that the safer route would be to go the MD route. You will be excluded from many places simply for being a DO. The DO schools are fine and they will give you a good education, but the reality is you will be limited, not totally excluded, but limited as to where you can train. I don't see an advantage to being a DO if cardiology is in your future.
 
My thoughts OP are that you will probably have an easier route to a competitive IM fellowship if you go the allopathic route.
However that is quite a distance in the future. Also note that residency even seems farther away I think from med students in their basic science years than pre-meds.

My opinion as a mere medical student myself is first go where you think you will be the most successful in school. That is the most important thing, to find which school fits you best, and accommodates your learning still the most.
 
If you want to do cards, MD will give you a better shot at it.

You have months to decide about the MD school. You may get into other places that you like within that time.
 
I just don't understand when people try to debate between their state MD school and DO school.

I don't know any DO school that ranks higher (research ranking) than a MD school, don't know any DO school that costs cheaper than the cheapest state MD school (and DO schools are more expensive than even some private MD in general), and I don't know why you would leave your state to go to a school that both cost more and isn't as prestigious.
 
YA7ES said:
I'm facing a tough decision. I've been accepted to my state MD school and a DO school that I love. As of right now, I want to do a residency in internal medicine (which falls in line with the DO route) and then subspecialize in something like pulmonology or cardiology.
Will being a DO put me at a disadvantage for subspecializing?
Do osteopathic residencies let you subspecialize when you are done?
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That's a tough decision for you? Seriously? :laugh:
Unless you have some sort of affinity for OMT and for being treated like a 2nd class citizen in the ACGME residency and fellowship matches, go to the MD school and don't look back.
I'm curious why you think being a DO is more compatible with practicing Internal Medicine than an MD. The last time I checked, there were exactly zero osteopathic residents at Mount Sinai's, Columbia's and NYH-Cornell's IM residencies.
 
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This is a no brainer....Go to the MD school. It is cheaper and will make things a little easier for you in the future.
 
Go to the cheaper school unless it was so malignant you can't stand the thought of being there. With health care reform around the corner and student loans a HUGE deal these days, you want as little debt as possible.
 
Adding onto this thread since my question kind of relates to the topic...

Are there very many DO Fellowships in IM subspecialties? I'm only a premed (MS-0), but I'm interested in ID and Rhem (always had an interest in ID since I was young, and have been shadowing/doing research under a rheum for 2+ years) and was wondering if there are many oppurtunities to land DO fellowships in these subspecialties. It's likely that my interests may change, and the fact that these arn't very well reimbursed specialities may be a factor in my decision in the future.... but I'd like to have the option open.
 
Black Adder said:
Adding onto this thread since my question kind of relates to the topic...

Are there very many DO Fellowships in IM subspecialties? I'm only a premed (MS-0), but I'm interested in ID and Rhem (always had an interest in ID since I was young, and have been shadowing/doing research under a rheum for 2+ years) and was wondering if there are many oppurtunities to land DO fellowships in these subspecialties. It's likely that my interests may change, and the fact that these arn't very well reimbursed specialities may be a factor in my decision in the future.... but I'd like to have the option open.
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There are AOA fellowship programs and ACGME fellowship programs, not "DO Fellowships". The AOA programs accept only osteopathic applicants and are few and far between, usually in smaller community hospitals. The ACGME programs are more widespread and accept American MDs, DOs, and FMGs, depending on their level of competitiveness.

As a DO you can train in an ACGME or AOA fellowship program. In general you need to do an ACGME Internal Medicine residency to do ACGME fellowship training, although less competitive ACGME fellowship programs in specialties like Rheumatology or Infectious Diseases sometimes accept residents from AOA Internal Medicine programs rather than leave a position vacant.

You might want to PM JayneCobb from the IM forum about specific questions regarding osteopathic IM fellowship opportunities.
 
wanna_be_do said:
There are AOA fellowship programs and ACGME fellowship programs, not "DO Fellowships". The AOA programs accept only osteopathic applicants and are few and far between, usually in smaller community hospitals. The ACGME programs are more widespread and accept American MDs, DOs, and FMGs, depending on their level of competitiveness.

As a DO you can train in an ACGME or AOA fellowship program. In general you need to do an ACGME Internal Medicine residency to do ACGME fellowship training, although less competitive ACGME fellowship programs in specialties like Rheumatology or Infectious Diseases sometimes accept residents from AOA Internal Medicine programs rather than leave a position vacant.

You might want to PM JayneCobb from the IM forum about specific questions regarding osteopathic IM fellowship opportunities.
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Thanks for the information! I found a link to the AOA approved residencies... saw for myself that there's hardly anything in ID or Rheum. Don't know if that was the right place to look, but if it was then it looks like I'd pretty much have to do an ACGME IM residency to have a good shot at getting those ACGME fellowships..
 
Good GOD go to the MD school...

I am thankful to the Osteo- world for the chance to become a physician, but it has been so much more difficult than it would have been as an MD. Examples: being rejected by patients on rotations due to "unknown credentials"; having clerkships canceled by preceptors (this happened twice) when they found out I was an osteopathic student; having to take two sets of boards for better opportunity; trying to keep a straight face when cranial osteopathy was presented as a legitimate topic in class.
 
hooperg said:
Good GOD go to the MD school...

I am thankful to the Osteo- world for the chance to become a physician, but it has been so much more difficult than it would have been as an MD. Examples: being rejected by patients on rotations due to "unknown credentials"; having clerkships canceled by preceptors (this happened twice) when they found out I was an osteopathic student; having to take two sets of boards for better opportunity; trying to keep a straight face when cranial osteopathy was presented as a legitimate topic in class.
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Since when do patients ask students for there credentials? Ive had nothing but excellent experiences in my 3rd year so far...
 
I have never been denied by a patient because I was a DO student, nor have I ever had a preceptor cancel my rotation because I was a DO student.

Hooperg, you really should get out of West Virginia or try rotating somewhere else - truly, not everywhere will give as bad an impression as you have experienced. Wheeling has a large osteopathic community.... so does Charleston. Perhaps you had bad rotation scheduling?
 
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The two cancellations did not occur in WV as most patients in WV know very well what DOs are.

The patients that questioned me were in a private office in NJ (and very old). One had this idea in mind that I was a "chiropractor and didn't know the first thing about his gout."
 
ShyRem said:
I have never been denied by a patient because I was a DO student, nor have I ever had a preceptor cancel my rotation because I was a DO student.

Hooperg, you really should get out of West Virginia or try rotating somewhere else - truly, not everywhere will give as bad an impression as you have experienced. Wheeling has a large osteopathic community.... so does Charleston. Perhaps you had bad rotation scheduling?
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Shyrem, are you suggesting that because it never happened to you, that people don't discriminate against DOs? Or that it was hooperg's fault somehow? Your naivete seems to be showing here. I can assure you that in the real world, some people have no desire to be seen by an osteopathic physician and would prefer an MD. Is it fair? Not really, but it's the truth.
 
I'm suggesting that it isn't that way everywhere. I'm suggesting that perhaps hooperg's experience may be one side of the coin and mine another. I'm suggesting that perhaps the road doesn't have to be as difficult as hooperg's experience. I'm suggesting that perhaps hooperg's advice is tainted by a bad experience that may not be everyone else's experience.

I'm not naive. By any means. But I know people who refuse to see an MD and only want to see a DO. And I also know people who refuse to see a DO and only want to see an MD. It is important to show a balanced view to someone asking for advice and if someone is going to give out their horrible experience, then a good experience should also be heard. Otherwise the OP makes an uninformed decision. What, you would have them think every single DO student gets kicked out of rooms and rotations just because they're a DO? That would not be the truth.
 
hooperg said:
Good GOD go to the MD school...

I am thankful to the Osteo- world for the chance to become a physician, but it has been so much more difficult than it would have been as an MD. Examples: being rejected by patients on rotations due to "unknown credentials"; having clerkships canceled by preceptors (this happened twice) when they found out I was an osteopathic student; having to take two sets of boards for better opportunity; trying to keep a straight face when cranial osteopathy was presented as a legitimate topic in class.
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🙄 None of this has happened to me or my classmates or anyone in any hospital I've been in. Students from our school rotated at Yale, Mayo, and Hopkins. Might I suggest it's not the letters after your name but the way you conduct yourself that turns people off?

Edit: and yes, our school has rotations throughout NJ
 
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J1515 said:
🙄 None of this has happened to me or my classmates or anyone in any hospital I've been in. Students from our school rotated at Yale, Mayo, and Hopkins. Might I suggest it's not the letters after your name but the way you conduct yourself that turns people off?

Edit: and yes, our school has rotations throughout NJ
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You raise an interesting point. While some Ivy Leagues are are known to discriminate against DOs for the sake of prestige, other Ivy League programs (ironically, in comparison to lesser known rural institutions that may discriminate) reflect a progressive, well-rounded attitude that one would expect from a quality training site secure enough in its reputation...Overall, Yale and Harvard are "DO-friendlier."

Also, as far as discrimination by patients...My guess is that hooperg's patients just didn't want to be seen by a student period, regardless of allo or osteo. I'm not in denial about DO-discrimination, but let it be known that in general, at least in my city, patients in wealthier parts of town will tend to question who is seeing them and tend to refuse residents and students more frequently. Even in poorer parts of town, patients sometimes have the attitude that they are being "jipped" when introduced to a student-physician (i.e. "oh i have medicaid so a doctor won't see me?).

Mt. Sinai and Cornell NY Presbyterian in the Upper East Side of Manhattan (where the money is) are known to have these type of patients (and none of us will deny that both of their respective med schools and ressies are quality tier allo).
 
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clement said:
You raise an interesting point. While some Ivy Leagues are are known to discriminate against DOs for the sake of prestige, other Ivy League programs (ironically, in comparison to lesser known rural institutions that may discriminate) reflect a progressive, well-rounded attitude that one would expect from a quality training site secure enough in its reputation...Overall, Yale and Harvard are "DO-friendlier."

Also, as far as discrimination by patients...My guess is that hooperg's patients just didn't want to be seen by a student period, regardless of allo or osteo. I'm not in denial about DO-discrimination, but let it be known that in general, at least in my city, patients in wealthier parts of town will tend to question who is seeing them and tend to refuse residents and students more frequently. Even in poorer parts of town, patients sometimes have the attitude that they are being "jipped" when introduced to a student-physician (i.e. "oh i have medicaid so a doctor won't see me?).

Mt. Sinai and Cornell NY Presbyterian in the Upper East Side of Manhattan (where the money is) are known to have these type of patients (and none of us will deny that both of their respective med schools and ressies are quality tier allo).
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The issue I have with DO students/residents coming on here and bashing the profession with their tales of woe is that we are only hearing one side of the story. I have rotated with fellow DO students who were lazy and immature, could never be found during the day, barely possessed the knowledge of a 1st year medical student, and then they said that the PD was prejudice against DOs when they got a bad evaluation. Same thing as the DO student who gets an average score on the COMLEX and a 220 on the USMLE and then complains that they aren't getting interviews to allopathic general surgery programs because they're a DO.

If it is indeed true that a patient asked what a DO was and then refused to see them, I think there's more to the story than what's being told. If you started saying "we take a more holistic approach" or "we relieve strain on the body allowing the body to heal itself" - then yes, anyone in their right mind would not let you near them. If you said "100 years ago DOs had a more holistic approach to their medical education and patient treatment, but now it has merged with allopathic medicine and is the same thing as an MD" then you're fine. I've never once had a patient refuse to see me (old or young) when I gave that response, the one or two times it has actually come up. Then there are patients like Clement said who don't want to see a student or resident period, and somehow our fragile little egos can't take that and need to place the blame somewhere.

It's a lot easier to blame the letters after your name than admit you just aren't as good as you think. This seems to be the case in 95% of the so called DO prejudices I hear of.
 
Oooooo. A few raw nerves it seems. I guess that is to be expected with a gallery of shoulders bearing chips. That's quite all right though--mine has one too, but at least I admit it. Not admitting such means one of two things:

1. You're lying and have massive insecurity in addition to an identity complex.
2. You've transcended the obstacles, belittlement, questioning, and ridicule to become a true D.O. zen master 😉.

It's certainly to be expected though, because it is a very natural reaction to become bitter and insecure when your credentials, choices, and very profession are maligned by other medical professionals, patients, family acquaintances, and friends just to name a few. Perhaps I've just been unfortunate to have such excessive exposure, but denying that it exists or marginalizing my experiences simply because it hasn't happened to you is both immature and idiotic.

I would like to think that my behavior, both soliciting new rotations and patient encounters is of the highest professionalism. My grades and letters of recommendation reflect this, but I'm not perfect. However, in each of the two instances (in 2 years) that I've been rejected by patients for credentials, it was after explaining exactly what osteopathic medicine was. They would NOT budge. I suppose in their ancient minds, only MD = doctor.

As for preceptor cancellations, this occurred with an anesthesia rotation and a radiology rotation with one physician even calling me after discovering I was from a D.O. school and stating "I'm sorry, but I can't facilitate your alternative learning requirements." I'm not exactly sure what he expected to be different for a D.O. student's radiology studies :laugh:.

Yes, my experiences of this type of discrimination are very real and very discouraging, but all one can do is function as the best possible physician and soldier on. Perhaps when the staunch, anti-DO generation of MDs and the unique-identity-guard DOs finally retire (or die) can we be equal.

My initial point to the OP was to avoid this whole litany of inconvenience, discrimination, cost excesses, and exhaustive self-defense and attend the MD school since it's available.
 
hooperg said:
Oooooo. A few raw nerves it seems. I guess that is to be expected with a gallery of shoulders bearing chips. That's quite all right though--mine has one too, but at least I admit it. Not admitting such means one of two things:

1. You're lying and have massive insecurity in addition to an identity complex.
2. You've transcended the obstacles, belittlement, questioning, and ridicule to become a true D.O. zen master 😉.

It's certainly to be expected though, because it is a very natural reaction to become bitter and insecure when your credentials, choices, and very profession are maligned by other medical professionals, patients, family acquaintances, and friends just to name a few. Perhaps I've just been unfortunate to have such excessive exposure, but denying that it exists or marginalizing my experiences simply because it hasn't happened to you is both immature and idiotic.

I would like to think that my behavior, both soliciting new rotations and patient encounters is of the highest professionalism. My grades and letters of recommendation reflect this, but I'm not perfect. However, in each of the two instances (in 2 years) that I've been rejected by patients for credentials, it was after explaining exactly what osteopathic medicine was. They would NOT budge. I suppose in their ancient minds, only MD = doctor.

As for preceptor cancellations, this occurred with an anesthesia rotation and a radiology rotation with one physician even calling me after discovering I was from a D.O. school and stating "I'm sorry, but I can't facilitate your alternative learning requirements." I'm not exactly sure what he expected to be different for a D.O. student's radiology studies :laugh:.

Yes, my experiences of this type of discrimination are very real and very discouraging, but all one can do is function as the best possible physician and soldier on. Perhaps when the staunch, anti-DO generation of MDs and the unique-identity-guard DOs finally retire (or die) can we be equal.

My initial point to the OP was to avoid this whole litany of inconvenience, discrimination, cost excesses, and exhaustive self-defense and attend the MD school since it's available.
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If it's worth anything ... I've never, in 2 + years on SDN, heard of a preceptor canceling because they found out you were a DO. Frankly, it sounds like your rotations were really iffy at your school, and you were responsible to do the leg work for yourself ... which is far more likely to bring up these weird bumps in the road, ESPECIALLY if this was a core rotation.
 
JaggerPlate said:
If it's worth anything ... I've never, in 2 + years on SDN, heard of a preceptor canceling because they found out you were a DO. Frankly, it sounds like your rotations were really iffy at your school, and you were responsible to do the leg work for yourself ... which is far more likely to bring up these weird bumps in the road, ESPECIALLY if this was a core rotation.
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Yes sir, that is EXACTLY the case and probably the defining reason for these experiences.

We are required to plan our entire 4th year. This requires calling every institution/office, faxing paperwork, arranging housing, and ensuring that core rotation graduation requirements are met. I've spoken with a few classmates and many of them have run into similar discrimination (New York/Carolinas especially), but not to my extent.

The freedom is nice, but it becomes exceptionally stressful and problematic if cancellations arise--either in housing or rotation.

Edit: Any other free-schedulers with similar experiences?
 
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hooperg said:
Yes sir, that is EXACTLY the case and probably the defining reason for these experiences.

We are required to plan our entire 4th year. This requires calling every institution/office, faxing paperwork, arranging housing, and ensuring that core rotation graduation requirements are met. I've spoken with a few classmates and many of them have run into similar discrimination (New York/Carolinas especially), but not to my extent.

The freedom is nice, but it becomes exceptionally stressful and problematic if cancellations arise--either in housing or rotation.

Edit: Any other free-schedulers with similar experiences?
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UGH, what a nightmare ... I can't even imagine. I'd be just as upset.
 
At UNE we have to plan our entire 4th year as well. I've had a few problems back in my own home state, Maine, with some rotations I wanted to do. But it had nothing to do with being a DO... the physicians didn't want any students at all. Even DO attendings who had previously taken students were not taking ANY students this year. Discouraging to say the least. But I have had some wonderful successes. Ophthomology for one. But I couldn't get a pulmonology rotation. No derm rotation other than cosmetic derm. I did find Ohio to be very helpful in getting rotations. Their hospitals have online application for the most part and are very responsive, even to out of state students. Most places provide housing. The downside is that you're away from home. Paperwork is handled by our administration at UNE.

sorry you're having such a hard time. Your school should at least handle paperwork. I really haven't found setting up fourth year to be that bad, though. Except in Maine. 🙁
 
hooperg said:
Yes sir, that is EXACTLY the case and probably the defining reason for these experiences.

We are required to plan our entire 4th year. This requires calling every institution/office, faxing paperwork, arranging housing, and ensuring that core rotation graduation requirements are met. I've spoken with a few classmates and many of them have run into similar discrimination (New York/Carolinas especially), but not to my extent.

The freedom is nice, but it becomes exceptionally stressful and problematic if cancellations arise--either in housing or rotation.

Edit: Any other free-schedulers with similar experiences?
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We scheduled our entire 4th year at NYCOM as well, much like most MD and DO schools do. Every rotation I requested/scheduled, I emailed or called the PD and introduced myself as j1515, a 4th year medical student from NYCOM. Everyone knew I was from a DO school and had no problems with it. I have no idea where you are coming up with this stuff. Oh, and I did all my rotations all over new york and jersey.
 
hooperg said:
Oooooo. A few raw nerves it seems. I guess that is to be expected with a gallery of shoulders bearing chips. That's quite all right though--mine has one too, but at least I admit it. Not admitting such means one of two things:

1. You're lying and have massive insecurity in addition to an identity complex.
2. You've transcended the obstacles, belittlement, questioning, and ridicule to become a true D.O. zen master 😉.
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No insecurity here. I'm at an allopathic residency filled with MDs and get treated exactly the same way. Nobody has ever chastized me for being a DO. In fact I joke around and make fun of myself for it with the other residents.

Again, we are only getting one side of your story. Nobody knows how you portray yourself to doctors and patients. It's easy to come on here and blame all your problems on your initials.

hooperg said:
However, in each of the two instances (in 2 years) that I've been rejected by patients for credentials, it was after explaining exactly what osteopathic medicine was. They would NOT budge. I suppose in their ancient minds, only MD = doctor.
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Can you tell us what you told these patients?

btw - 2 times in 2 years is what you're complaining about? Students get told all the time that patients don't feel comfortable being examined by them simply because they're a student.
 
J1515 said:
Can you tell us what you told these patients?
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Sure. In each instance, I told them that osteopathic medicine was a branch that diverged from traditional allopathic medicine in the 1800s, but has since come full circle. Along the way, it has kept some manual techniques that some practitioners use as an extra treatment tool, but otherwise we do the same stuff. (Despite my bitching on this forum, I really, really, really do my best to advocate and educate for the profession :laugh:.)

There is a major difference between being shot down for being a student (which does happen often) and being shot down for being a D.O. student. Yes, it has only happened twice in two years, but the experiences have stuck with me.

Shyrem, they do handle a lot of the legal, nitty-gritty paperwork, but errors/cancellations and lagtime are rampant because of administrative BS. In some cases, rotation sites demand that we (the student) pay them upwards of $3000 in order to "establish affiliation" with our school. Yes, they are telling us that it is our responsibility to PAY them (this was a friend's experience in Colorado). It's getting better though.
 
hooperg said:
Sure. In each instance, I told them that osteopathic medicine was a branch that diverged from traditional allopathic medicine in the 1800s, but has since come full circle. Along the way, it has kept some manual techniques that some practitioners use as an extra treatment tool, but otherwise we do the same stuff.
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And therein lies the problem. This isn't the COMLEX PE. Most real patients don't want to hear about the history of osteopathic medicine or OMM. A simple "it's the same as an MD...100 years ago our medical education was based on a different philosophy but it's the same now" is all you need.


Regardless, your two isolated experiences aren't reason enough to tell people to run the other way from DO schools. There are more people saying they've been treated exactly the same as MD students than there are people complaining. Another former DO student on here always used to post how awful his rotations were and how none of the doctors respected him. Then it was uncovered that instead of focusing his effort on learning/practicing medicine he was more interested in personal interest groups and promoting gays and lesbians in medicine. I'm sure that would pi$$ off anyone program director. I've heard secondhand that places like Columbia and NYU are reluctant to accept DOs in their residencies, so I won't say there is zero bias throughout the country. But 99/100 times when DO students start bitching about something, it's attributed to their own inadequacies rather than the initials.

I'm not quite sure how you can even schedule a rotation without them knowing what school you are from, so that story seems a bit shady to me. We always would have an email or written confirmation faxed to the school from the clerkship director approving the rotation and our school kept it on file (hence they knew our school and that we were DOs). The school required this confirmation before starting the rotation.
 
J1515 said:
And therein lies the problem. This isn't the COMLEX PE. Most real patients don't want to hear about the history of osteopathic medicine or OMM. A simple "it's the same as an MD...100 years ago our medical education was based on a different philosophy but it's the same now" is all you need.


Regardless, your two isolated experiences aren't reason enough to tell people to run the other way from DO schools. There are more people saying they've been treated exactly the same as MD students than there are people complaining. Another former DO student on here always used to post how awful his rotations were and how none of the doctors respected him. Then it was uncovered that instead of focusing his effort on learning/practicing medicine he was more interested in personal interest groups and promoting gays and lesbians in medicine. I'm sure that would pi$$ off anyone program director. I've heard secondhand that places like Columbia and NYU are reluctant to accept DOs in their residencies, so I won't say there is zero bias throughout the country. But 99/100 times when DO students start bitching about something, it's attributed to their own inadequacies rather than the initials.

I'm not quite sure how you can even schedule a rotation without them knowing what school you are from, so that story seems a bit shady to me. We always would have an email or written confirmation faxed to the school from the clerkship director approving the rotation and our school kept it on file (hence they knew our school and that we were DOs). The school required this confirmation before starting the rotation.
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I will take your advice and shorten/pinpoint the explanation as you stated when asked about it.

Columbia much more than NYU. Columbia will not even provide us with clerkships.

I did not just list two isolated incidents, I listed a number of reasons to take his in-state MD acceptance. Aside from money being a huge factor, the other reasons are there; I was only drawing from my own experiences to reinforce my point.

The individual about whom you speak... I think I've seen his posts on here frequently, lol. I agree mostly with your assessment.
 
since when does NYU discriminate against DO's?

Nader Paksima D.O., MPH is a clinic director at the orthopod dept for NYU hospital for joint diseases------he went to NYCOM.

Also i personaly know a couple of NYCOM grads who have matched into the program.....
 
donkeykong1 said:
since when does NYU discriminate against DO's?

Nader Paksima D.O., MPH is a clinic director at the orthopod dept for NYU hospital for joint diseases------he went to NYCOM.

Also i personaly know a couple of NYCOM grads who have matched into the program.....
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Many students don't grasp the difference between being an attending at an institution vs. being a resident.

Dr. Paksima has a great reputation and I'm sure is a terrific orthopedist but the fact is that he trained at an osteopathic orthopedic residency (Peninsula). Very few osteopaths train in ACGME orthopedic surgery programs. The year I graduated, one classmate got into the St. Vincent's NY ortho program, at best a middle of the road residency in the ACGME ortho world, but the fact that he even got in was absolutely amazing at the time.

Institutions with competitive ACGME residencies don't like taking DOs or FMGs into those residencies. Program directors there usually have their pick of the cream of the crop American MD applicants, and often don't see the need to accept or even interview a DO or an FMG.

Being an attending is different. A surgeon in private practice, especially an orthopedist, can earn significantly more in the community than in an academic practice. Additionally, academic practices are under pressure now to be productive in terms of patient volume in addition to research. It used to be that academic physicians would spend more time writing papers and doing research than actually seeing patients, but those days are gone. In short, the actual benefit of being in academia is fading, and the competitiveness in gaining a faculty position has decreased somewhat as a result. I have no doubt that Dr. Paksima is a great surgeon, as are the other DOs who are faculty at elite institutions, but them being there does not at all imply that an institution has no DO bias (or "MD preference") in their residency program selection. If you actually look at the NYU ortho residents , none are DOs, at least from the R-1s I looked up.

NYU does take DOs in some of their other programs, most notably PM&R, but again this is reflective of the actual desirability of the residency. PM&R is known for being rather uncompetitive and as a result NYU accepts DOs and FMGs rather than having slots going unfilled (and losing residency funding).
 
ok, then what I dont understand is why don't DOs stand up against this bias? they can be great academic contributors to prestigious institutions that carry ACGME residencies but they cant match into them? something has got to change.

this seems twisted and awful....
 
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donkeykong1 said:
ok, then what I dont understand is why don't DOs stand up against this bias? they can be great academic contributors to prestigious institutions that carry ACGME residencies but they cant match into them? something has got to change.

this seems twisted and awful....
Click to expand...

It's bias from the point of view of a DO trying to match ACGME ortho. Frankly, it's really not from any other angle. DOs are allowed to match ACGME ortho, but MDs can't match AOA ortho (which I'm fine with to be honest), the AOA isn't paying the PDs, nor does the hospital get reimbursed for any DO students (unless they charge for an audition rotation or something). It's a competition. If a DO wants to match, he/she needs to be badass and better than the MD applicants. However, if that PD isn't familiar with DOs or wants to take MD applicants, I suppose that is unfair, but frankly, DOs match alright into MD ortho programs, and if this is one with old school bias or that doesn't want DOs ... that's just how it is. Is it completely just and fair?? No, but neither is life. I think the fact that DOs are given the opportunity to apply for these residencies in the first place is pretty cool, and programs end up taking the 'first DO' all the time. This one could do that in time, who knows. Plus, having a DO in the position you stated can only help the case.
 
Unless you're getting some redicious scholarship to the DO school (and even then, it's not a slam dunk), just go to the MD school, there's no reason not to. At the very least it'll give you all the opportunities the DO school would have... at the most, should you decide to go into some competitive specialty down the road, it'll make things much easier for you (and really, you can't have realistically made up your mind about what you want to do before even starting med school, these things change as you go along, don't limit your options)
 
gis2011 said:
Unless you're getting some redicious scholarship to the DO school (and even then, it's not a slam dunk), just go to the MD school, there's no reason not to. At the very least it'll give you all the opportunities the DO school would have... at the most, should you decide to go into some competitive specialty down the road, it'll make things much easier for you (and really, you can't have realistically made up your mind about what you want to do before even starting med school, these things change as you go along, don't limit your options)
Click to expand...

Keep in mind that there are ortho residencies sponsored by the AOA that only DO students can apply to. I'm not going to get into your point, just saying ...
 
My question from all of this is about something hooperg said about having to pay to establish an affiliation. Is this common? I don't mind setting up my 4th yr rotations, but do we have to pay for all of them? I hadn't heard of this until he/she mentioned it, so I don't know if that is something common that I need to look into when planning/researching schools.
 
donkeykong1 said:
ok, then what I dont understand is why don't DOs stand up against this bias? they can be great academic contributors to prestigious institutions that carry ACGME residencies but they cant match into them? something has got to change.

this seems twisted and awful....
Click to expand...

LOL stand up to who? The ACGME? It's basically a courtesy that we are even allowed to match into any of their residencies to begin with. There is no law forbidding discrimination on the basis of medical degree.

I think there is something else one needs to understand about competitive residencies and being a DO applicant (or an FMG). Even though it seems unfair, having DOs or FMGs in an ACGME residency program sends a message that the program isn't that competitive. It doesn't matter if the DO/FMG scored 260+ on the USMLE or was a member of their honor society or whatever.

An acquaintance of mine works as an attending in an "Ivy" institution - the first DO in his specialty there. He has had students from the affiliated medical school rotating primarily on his service. He noticed a few months into his new job that the students preferred to not rotate with him. He initially chalked it up to DO bias but when he asked about it he got the answer, which was a little more complicated. As a DO, a recommendation letter from him probably would carry zero weight to any of the upper-tier residencies his students were interested in, and his specialty was competitive enough that that could make a difference in their chances to match. Additionally, his perspective as a DO wasn't very relevant to their residency selections. When the students are comparing the merits of programs at MGH vs. Yale vs. Columbia, Mount Sinai, etc, what constructive input can a DO offer who didn't even come close to scoring those interviews?

Anyhow, this thread is straying a bit from the originally posed question, but my opinion is still the same - an American MD program is still the better option if you want to ultimately do an ACGME residency.
 
wanna_be_do said:
As a DO, a recommendation letter from him probably would carry zero weight to any of the upper-tier residencies his students were interested in, and his specialty was competitive enough that that could make a difference in their chances to match. .
Click to expand...

Probably, huh? I don't see how a letter from an MD at a program who isn't famous and no one knows (assuming they are young like your friend) is going to be any different from a DO at the exact same program who no one knows?? Maybe I'm reading it wrong. I get it if there is some old famous MD handing out letters, but if it's two young jerk-offs that old PDs wouldn't know if they punched em in the face ... who cares??

'This student is good'
-Dr X

'This student is good'
-Dr Y

which one is the DO?? It's of course, Dr X. This is why the students avoided him and only got letters from Dr Y. Of course I'm being an ass and truly don't know anything about this higher up process, but it sounds like the annoying pre-allo kids all grown up and still being annoying, exhibiting mob mentality, and acting paranoid.
 
JaggerPlate said:
Probably, huh? I don't see how a letter from an MD at a program who isn't famous and no one knows (assuming they are young like your friend) is going to be any different from a DO at the exact same program who no one knows?? Maybe I'm reading it wrong. I get it if there is some old famous MD handing out letters, but if it's two young jerk-offs that old PDs wouldn't know if they punched em in the face ... who cares??

'This student is good'
-Dr X

'This student is good'
-Dr Y

which one is the DO?? It's of course, Dr X. This is why the students avoided him and only got letters from Dr Y. Of course I'm being an ass and truly don't know anything about this higher up process, but it sounds like the annoying pre-allo kids all grown up and still being annoying, exhibiting mob mentality, and acting paranoid.
Click to expand...

I think what he's trying to get that is that the pathway of education is likely so different (the DO attending probably went to a community residency just by sheer statistic) that the DO attending cannot help when it comes to some of the stuff, you know, like choosing between big name academic places for residency.
 
Handy388 said:
I think what he's trying to get that is that the pathway of education is likely so different (the DO attending probably went to a community residency just by sheer statistic) that the DO attending cannot help when it comes to some of the stuff, you know, like choosing between big name academic places for residency.
Click to expand...

Yeah, who know? Probably. Like I said, I was just playing around/don't pretend to know how it really works at that level. It's above my pay grade. Personally though, I think I'd round/get close to ANY attending I could.
 
Someone earlier mentioned that it is much more difficult for DO's to get into MD fellowships than for DO's to get into MD residencies. I'm curious if anyone knows or can speculate as to how much it matters? I always guessed that fellowships would be based more on how well you performed during residency. Just for heck of it, how about a scenario where a DO is coming out of a USC residency (from what I researched, there are a decent amount of DO's there) and decided they wanted a decently competitive fellowship such as Nephrology or Pulmonary. Would he/she be extremely limited?
 
LastPolarBear said:
Someone earlier mentioned that it is much more difficult for DO's to get into MD fellowships than for DO's to get into MD residencies. I'm curious if anyone knows or can speculate as to how much it matters? I always guessed that fellowships would be based more on how well you performed during residency. Just for heck of it, how about a scenario where a DO is coming out of a USC residency (from what I researched, there are a decent amount of DO's there) and decided they wanted a decently competitive fellowship such as Nephrology or Pulmonary. Would he/she be extremely limited?
Click to expand...

I'd assume the same thing you did ... IE complete an ACGME residency and fellowships are going to care about what you did in residency, not where you went to medical school. I think it would be like medical schools judging you on what you did in high school and ignoring what you did in college? Who knows though??? It's a funny/tricky game when you get to that level (from what I'm learning), and I think a lot of what happens is a case by case basis and involves a lot of factors that we can't really analyze by just guessing facts and making hypothetical arguments on SDN. Maybe some fellows will come in here and give some knowledge.
 
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